An apparatus and method to deliver intensity modulated radiation therapy by irradiating a treatment volume with rotation of the radiation beam. The system includes a collimation device comprising a two-dimensional array of pivoting attenuating leaves, which are temporarily placed into the radiation beam path as the gantry rotates around the patient. The leaves are independently movable between a first position and a second position. The radiation beam intensity is modulated by controlling the time that each leaf is present to attenuate the beam.